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There is a high incidence of smoking-related deaths in the US in the general population, with even higher rates in diabetic patients. Several epidemiological studies have linked smoking with insulin resistance, an early and potentially modifiable metabolic defect in the pathogenesis of type II diabetes [16,17]. They have also shown a correlation between tobacco consumption and the incidence of diabetes [18,19], and cardiovascular complications [10,20].

The routine assessment of tobacco use and smoking cessation counseling is of vital importance in the preventive care and long-term management of type II diabetes.

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